Delivery

What are possible labor complications?

Although serious complications are rare during labor, some problems can develop during
this time. Some of the more common complications include:

Fetal meconium

When the amniotic sac ruptures, the normal color of the amniotic fluid is clear. However,
if the amniotic fluid is greenish or brown in color, it may show fetal meconium, which
is normally passed after birth as the baby's first bowel movement. Meconium in the
amniotic fluid may be associated with fetal distress. A woman should talk with her healthcare
provider immediately.

Abnormal fetal heart rate

The fetal heart rate during labor is a good sign of how the fetus is handling the
contractions of labor. The heart rate is usually electronically monitored during labor.
The normal range varies between 120 and 160 beats per minute. If a fetus appears to
be in distress, immediate action can be taken. The mother can be given oxygen, increase
fluids, and change her position.

Abnormal position of the fetus during birth

The normal position for the fetus during birth is head-down, facing the mother's back.
However, sometimes a fetus is not in the right position, making delivery more difficult
through the birth canal. There are several abnormal positions for a fetus, including
the following:

Positioned head-down but facing the mother's front

Positioned with the face down into the mother's pelvis, instead of the top of the
fetal head

Positioned with the brow down in the mother's pelvis

Positioned breech (where the buttocks or feet are down first in the mother's pelvis)

Positioned with 1 shoulder in the mother's pelvis

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Depending on the position, a healthcare provider may try to deliver the fetus as it
presents itself, attempt to turn the fetus before delivery, or perform a cesarean
delivery.

Delivery of the baby

Delivery is the moment when the fetus, followed by the placenta, exits the mother's
body. In preparation for the delivery, a woman may be moved into a birthing room or
delivery room. Or she may remain in the same room for both labor and delivery. Fathers
or partners are encouraged to be actively involved in the process of childbirth by
helping with relaxation methods and breathing exercises.

Positions for delivery may vary from squatting, sitting, to semi-sitting positions
(between lying down and sitting up). With semi-sitting positions, gravity can help
the mother push the baby through the birth canal. The type of position for delivery
depends on the preference of both the mother and the healthcare provider, as well
as the health of the fetus.

During the delivery process, the medical personnel will continue to keep an eye on
the mother's vital signs, like blood pressure and pulse, and the fetal heart rate.
The healthcare provider will examine the cervical opening to determine the position
of the fetus' head and will continue to support and guide the mother in her pushing
efforts.

Delivery can be done either vaginally or by cesarean section (C-section).

What is a vaginal delivery?

During a vaginal delivery, the healthcare provider will assist the fetus' head and
chin out of the vagina when it becomes visible. Once the head is delivered, the healthcare
provider applies gentle downward traction on the head to deliver the shoulder, followed
by the rest of the body. The baby turns itself as the last movement of labor.

In some cases, the vaginal opening does not stretch enough to accommodate the fetus.
It may be necessary to speed up delivery, for example, if the baby is in distress.
In such cases, the healthcare provider may perform an episiotomy. This is a cut through
the vaginal wall and the perineum. This are is between the thighs, extending from
the anus to the vaginal opening. An episiotomy is done to help deliver the fetus.
Episiotomies are not needed for every delivery and are not routinely performed.

After the delivery of the baby, the mother is asked to continue to push during the
next few uterine contractions to deliver the placenta. Once the placenta is delivered,
any tear or episiotomy is repaired. The mother is usually given oxytocin. This is
a drug given either by an injection into the muscles or intravenously that is used
to contract the uterus. The uterus is then massaged to help it contract, and to help
prevent excessive bleeding from happening.

What is a cesarean section (C-section)?

If a woman is unable to deliver the fetus vaginally, the fetus is delivered surgically,
by performing a cesarean section. Cesarean sections are usually performed in an operating
room or a designated delivery room. Some cesarean sections are planned and scheduled,
while others may be performed as a result of complications that occur during labor.

Once the anesthesia has taken effect, a cut is made in the stomach, and an opening
is made in the uterus. The amniotic sac is opened, and the baby is delivered through
the opening. The woman may feel some pressure and/or a pulling sensation.

Following the delivery of the baby, the healthcare provider will stitch the uterine
and the cut that was made in the stomach. After a cesarean or vaginal delivery, women
will have some bleeding.

Conditions for a cesarean section

There are several conditions that may make having a baby by cesarean section more
likely. These include:

Previous cesarean section

Fetal distress

Abnormal delivery presentation, like breech, shoulder, or face

A labor that fails to progress or does not progress normally

Placental complications. One example is placenta previa, in which the placenta blocks
the cervix. This raises the risk that the placenta will become detached too soon from
the uterus.